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Otorhinolaryngology News
Abreast Of Ear, Nose &
Throat / Head & Neck Advances
19 December, 2005
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Hello, All. You are Welcome
to this week's ORL Update. I do hope you find my picks
for this week exciting and useful |
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Biodun Olusesi,
Newsletter Editor |
Biofilms and CSOM.......
This week's main news takes a swipe at
bacterial biofilms - a concept that has been
generating immense interest among
otolaryngologists all over the world. To be
informed about biofilms basic, click
here.
For a previous paper linking Otitis
media with biofilms, Click
here to view the paper by
Peter S. Rowland.
Several papers have since been
published attempting to link bacterial biofilms to
perpetuation of chronicity of otological and
rhinological infections including otitis media,
chronic tonsillitis, rhinosinusitis and
tympanostomy tube otorrhoea. The first
disease-associated bacterial biofilms in non-human
primate model of CSOM was reported by Dohar et al
from Pittsburg (Laryngoscope.
2005 Aug;115(8):1469-72.), thus setting the stage
for applied clinical research in human model.
Abstract: BACKGROUND: An increased awareness
of bacterial biofilms and their formation has led
to a better understanding of bacterial infections
that occur in the middle ear. Perhaps the best
studied pathogen for its propensity toward biofilm
formation is Pseudomonas aeruginosa, also the
primary pathogen in chronic suppurative otitis
media (CSOM). OBJECTIVE: The aim of this study was
to determine whether P. aeruginosa forms a biofilm
in the middle ear in the setting of CSOM in a
nonhuman primate model. METHODS: Cynomolgus
monkeys underwent perforation of the tympanic
membrane and inoculation of the middle ear with a
known biofilm-forming strain of P. aeruginosa. The
contralateral ear was used as an internal control
and was neither perforated nor infected. At the
end of the study period, both ears were irrigated
to remove planktonic bacteria, and the middle ear
mucosa was removed and examined ultrastructurally
using scanning electron microscopy (SEM) for
determination of the presence or absence of
biofilm formation. MAIN OUTCOME MEASURE: The
identification of middle ear biofilm containing
rod-shaped bacteria. RESULTS: SEM revealed that P.
aeruginosa formed bacterial biofilm in vivo on the
middle ear mucosal surface, seen only in the
infected ear. Interestingly, biofilm formation
caused by cocci was also seen in both the
experimental as well as the control ear.
CONCLUSION: P. aeruginosa forms biofilms in the
middle ear in CSOM in primates. To our knowledge,
this is the first report of disease-associated
bacterial biofilm in a nonhuman primate model of
CSOM. Such a model lays a foundation for much
needed study into the role of biofilms in the
pathophysiology of CSOM. Should CSOM be caused by
biofilms, which is uncertain at this time,
development of novel strategies for treatment and
prevention may be possible. The finding of both
rods and cocci forming biofilms also warrants
further investigation
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TOP PICKS
 OSAS
and Pharyngeal calcification...
How can you link the presence of severe obstructive
sleep apnoea not responsive to continuous positive
airway pressure (CPAP) with detection of massive area of
tissue calcification in the pharynx? Well Eduardo B
Couri et al in a recent open access publication (BMC
Cardiovascular Disorders 2005, 5:34 , Dec
12, 2005 ) reported similar case and diagnosed
Monckeberg's sclerosis
Abstract:
Background:Since
its first description, Monckeberg's sclerosis (MS) has
only been related to arterial media calcification, being
listed among the primary diseases of the vessels.Case
presentation:We
report here a clinically and histologically confirmed
case of MS in which the patient presented with massive
areas of soft tissue calcifications in the pharynx.
Polysomnographic parameters showed severe obstructive
apnea refractory to nasal continuous positive airway
pressure. Clinical and laboratory findings excluded
concomitant endocrine or rheumatological diseases.
Conclusion:Our
data provide a new insight about MS, i.e., the fact that
the etiopathogenic process involved in the phenomenon of
calcification may not be restricted only to the
arteries, but may occur in the entire organism. Further
studies of the etiopathogenesis of this disease are
needed.
Coming Events of Importance to Otolaryngologists in
Africa...
- Annual West Africa
College of Surgeons Conference, Accra, Ghana, Feb
2006.
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Association of Paediatric Otolaryngologists of
India 12th Annual Conference and CME in Paediatric
Otolaryngology
February 25-26, 2006; New Delhi, India
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8th International Otology Course of the Jean Causse
Ear Clinic
June 22-24, 2006; Béziers, France
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110th American Academy of ORL,Head & Neck Surgery
Annual Meeting & OTO EXPO
September 17-20, 2006;
Toronto, Canada.
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42nd South African ENT Congress joint meeting with
the British Association of Otolaryngology - Head &
Neck Surgery
October 29-November 1, 2006;
Cape Town, South Africa.
For more courses and workshops and conferences....Click
Here
What influences the prognosis
in Sudden SNHL.....?
Aydin Mamark et al. in a recent study (
ENT - Ear, Nose &
Throat Journal • October 2005) reviewed 72
patients and concluded that
positive prognostic factors were the absence of
vertigo, the presence of tinnitus, initiation of
treatment within 7 days, a greater degree of hearing
loss in the low frequencies, and a hearing loss of less
than 45 dB.
 Abstract:
We investigated the prognostic significance of the
presence or absence of vertigo and tinnitus, the timing
of the initiation of treatment, the type and severity of
hearing loss, and age in 72 patients who had experienced
sudden hearing loss. We found that the factors
associated with a positive prognosis were the absence of
vertigo, the presence of tinnitus, initiation of
treatment within 7 days, a greater degree of hearing
loss in the low frequencies, and a hearing loss of less
than 45 dB. Age had no effect on prognosis.
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CLINICAL RADIOGRAPH OF THE WEEK |
 A
60-year old male presented with annoying clicking
sound heard in right ear during eating or opening
/ closure of the jaw. He also experiences
discomfort right ear during chewing. He had no
other symptoms, Otoscopy was not remarkable Examination showed
tenderness on deep palpation over right TMJ area.
Plain TMJ x-ray revealed the features seen
(white thin arrow) on this picture. You way want
to
compare the appearance of
left TMJ for clarity
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What is the diagnosis?
Parting Shot...
If you have an interesting
case to discuss or share with other Otolaryngologists
all over Africa, feel free to email
Me or at best go to
otolaryngology in Africa blogsite
and post your case
Also, if you are among those who requested for a copy
of DODA at the last ORLSON Meeting @ Port Harcourt,
please take time to view the
DODA - FAQ page,
and expect your copy of the program soon. The current
delay is due to adding more features to the DODA program
as well as pruning some features you might really not
need for initial assessments
Till Next Week,
Biodun |
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© Copyright Dr 'Biodun
Olusesi,
2005 |
